Paige Winfield Cunningham is a health-care correspondent for the Washington Examiner.
Everyone knows that hot pink stands for breast cancer. The second-leading cause of cancer death among women has given rise to perhaps the most effective anti-cancer campaign in U.S. history. But widespread public awareness hasn’t tamped down misperceptions about breast cancer and how it operates. Here are some myths you might still believe.
1. Breast cancer is mostly linked to family history.
Angelina Joliedrew a lot of attention to genetic contributors to breast cancer when she underwent a double mastectomy two years ago. Jolie decided to have both breasts removed after learning that she carries a mutation in the BRCA1 gene, a risk compounded by the fact that she lost her mother, grandmother and aunt to the disease.
Certain genetic mutations do dramatically increase the chances of getting breast cancer: Women with an abnormality in either the BRCA1 or the BRCA2 gene, for instance, have a 40 to 85 percent chance of developing it, compared with about a 12 percentchance among the general population. An estimated 1 in 400 to 800 people will inherit this mutation, which translates to 400,000 to 800,000 Americans.
But most breast cancer patients don’t have a family history of the disease. Only 5 to 10 percent of breast cancer cases are considered hereditary — and just 13 percent of patients have a mom or sister who also got it.
“This is an extremely common misperception,” said Richard Weinshilboum, chairman of clinical pharmacology at the Mayo Clinic College of Medicine. “Unfortunately and tragically there are many women who do develop cancer who do not have a family history.”
2. Birth-control pills increase the risk of developing the disease.
Many women believe that taking oral contraception increases breast cancer risk, a notion supported by numerous studies and trumpeted by opponents of birth control. But what’s less known is that not all birth-control pills increase the risk — just those with high levels of estrogen.
Last year, scientists at the Fred Hutchinson Cancer Research Centerfound that for women who had recently taken pills with high-dose estrogen, the risk of breast cancer was 2.7 times greater. The risk was 1.6 times higher for recent users of pills containing moderate-dosage estrogen. But the researchers found no greater risk associated with pills with low doses. The distinction matters; most women on the pill these days use moderate- or low-dose kinds. Of the study’s participants, fewer than 1 percent were taking a pill with high-dose estrogen, and overall, birth-control pills today contain about a fifth of the estrogen that oral contraceptives had when they debuted in the 1960s.
Furthermore, most women take the pill in their 20s and 30s, when they’re less likely to develop the disease anyway, and the slightly elevated risk decreases four years after a woman stops taking it. Simply growing older puts a woman at far greater risk of developing breast cancer than oral contraceptives do.
3. Larger breasts mean greater risk.
A slew of headlines suggesting a higher breast cancer risk among well-endowed women resulted from a 2012study by genetics firm 23andMe. But the correlation is far from proven. For one thing, the study identified only genetic variants that have an effect on both breast cancer risk and breast size — and the researchers admitted that much more research would be needed to establish a concrete link.
Previous studies have presented conflicting results. Two studies found that larger breasts elevate the risk among thin women but not among heavy women. Another study found the opposite: that women with smaller breasts may have a higher risk because of tissue density — but that makes for a less splashy headline.
4. All women should do a monthly breast self-exam.
For years, the monthly breast exam was the holy grail of cancer screening. Local newscasts aired segments showing women how to perform them. Doctors insisted — and often still do — that female patients practice them. Awareness groups handed out water-resistant cheat sheets women could refer to in the shower.
But the science shows that self-examsdon’t improve survival rates. In studies of Russian and Chinese women conducted over a decade, the rate of breast cancer deaths was almost identical among women trained in self-exams and among those who weren’t. Doing a self-exam can also lead to more unnecessary screenings, false-positive test results and biopsies with benign results. And by the time many women find lumps, their cancer has already been growing for several years.
Self-exams aren’t necessarily bad, experts say, but it’s more important for women to be aware of their breasts in the same way they monitor their bodies in general, rather than conducting an exam in a particular way each month. The leading breast cancer group agrees: Susan G. Komendoesn’t recommend self-exams as a screening tool.
5. Breast cancer research needs more money.
Policymakers and advocates spend so much time talking about breast cancer, you might think that its research was funded at lower levels than research on other cancers. “We must accelerate the progress we are making in finding new lifesaving treatments for breast cancer,” then-Rep. Shelley Moore Capito (R-W.Va.) said on the House floor in 2013.
But at least compared with other types of cancer, breast cancer research is swimming in money. Breast cancer gets eight times as much funding as lung cancer, even though lung cancer kills more women yearly. In total, breast cancer gets more than double the federal research funding of any other cancer.
The huge investment is thanks to a highly effective public-awareness push that began way before any other anti-cancer efforts. Komen has spread its influence through a huge network of partnerships: with the Dallas Cowboys, for example, as well as numerous corporations that sell pink products and donate a portion of the proceeds (though this has not been without controversy).
Another factor in breast cancer’s elevated funding level is its relatively low mortality rate. About 12 percent of women diagnosed with the disease die within five years — a rate much lower than for cancers of the lungs or pancreas, which kill a majority of patients five years out. That means there are lots of survivors around to rally the troops.
Plus, breasts get a lot of attention because they’re, well, breasts. Some groups have capitalized on that, giving rise to foundations with names like Save the Ta-Tasand Feel Your Boobies. Unfortunately for colon cancer, “Get a colonoscopy” is a lot less sexy.
Correction: An earlier version of this story incorrectly reported that Susan G. Komen is partnered with the NFL. In fact, Komen is partnered with the Dallas Cowboys, but not the NFL. The NFL’s breast cancer awareness campaign is done in partnership with the American Cancer Society.